Provider Demographics
NPI:1306002696
Name:KEVIN STINGLEY, DDS, PC
Entity type:Organization
Organization Name:KEVIN STINGLEY, DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:STINGLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-465-3233
Mailing Address - Street 1:139 S MAIN ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:MONTICELLO
Mailing Address - State:IA
Mailing Address - Zip Code:52310-1751
Mailing Address - Country:US
Mailing Address - Phone:319-465-3233
Mailing Address - Fax:319-465-7041
Practice Address - Street 1:139 S MAIN ST
Practice Address - Street 2:SUITE A
Practice Address - City:MONTICELLO
Practice Address - State:IA
Practice Address - Zip Code:52310-1751
Practice Address - Country:US
Practice Address - Phone:319-465-3233
Practice Address - Fax:319-465-7041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-06
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA068311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty